News

Not-for-profit health insurer Southern Cross Health Society funded 215,711 specialist appointments and procedures for children and young adults in 2015 – with the more expensive claims topping $50,000.

Southern Cross are releasing this information to improve transparency after research showed that many Kiwis are unaware about the costs of healthcare.

Most expensive individual children’s claims in 2015:

Age: 0 - 4	Paid	Age: 5 - 9	Paid
Femur alignment	$25,697	Cystectomy and bladder reconstruction	$23,953
Hernia Repair	$18,686	Cortical mastoidectomy	$18,281
Pelvis reconstruction	$16,605	Urethroplasty	$17,464
Abdominal wall access	$16,545	Nasal surgery	$14,861
Ureter reimplantation	$14,234	Modified radical mastoidectomy	$14,694
Age: 10 - 14	Paid	Age: 15 - 20	Paid
Colon removal	$32,156	Hip preservation	$54,184
Hip preservation	$31,739	Aortic valve replacement	$53,809
Radiofrequency ablation with cryotherapy	$29,150	Craniotomy	$43,804
Dislocation vs arthroscopy	$27,998	Craniotomy	$35,637
Kidney removal	$26,784	Arthroscopy - Wrist	$34,841

 

Age: 0 – 4	Price	Age: 5 - 9	Price
Simple Bilateral Ear Procedure	$1,900 - $2,600	Tonsillectomy	$3,600 - $4,600
Tonsillectomy	$3,600 - $4,600	Simple Bilateral Ear Procedure	$1,900 - $2,600
Adenoidectomy	$3,100 - $3,400	Removal of Teeth	$2,300 - $4,900
Hernia - Inguinal Repair	$5,800 - $7,450	Circumcision	$3,900 - $5,300
Circumcision	$3,900 - $5,300	Adenoidectomy	$3,100 - $4,100
Age: 10 - 14	Price	Age: 15 - 20	Price
Removal of Teeth	$2,300 - $4900	Removal of Teeth	$2,300 - $5,400
Tonsillectomy	$3,600 - $4,600	Tonsillectomy	$3,600 - $4700
Excision Skin Lesion	$3,500 - $4,900	Endometriosis Surgery	$9,700 - $13,300
Exposure of Unerupted Tooth	$1,400 - $2,700	Gastroscopy	$2,100 - $2,400
Gastroscopy	$2,000 - $2,400	Excision Skin Lesion	$3,600 - $5,000

While procedures such as tonsillectomies and grommet insertion were common, what was surprising was the range and seriousness of some of the procedures says Head of Provider Networks Geoff Searle.

“While GP visits are free for children under 13, this is proof that childhood conditions can often require specialist intervention,” says Searle.

“No parent would want their child to remain untreated any longer than necessary. But we have to acknowledge that kids without life threatening conditions often wait to get treated on public lists - this is why children make up such a large amount of the Southern Cross membership.”

Southern Cross has 191,975 members who are under 21 – equalling 23% of the total membership.

As a not-for-profit, Southern Cross Health Society has a responsibility to add value for our members.

The Society manages the inflation of medical procedures through their Affiliated Provider programme - where specialists surgeons and facilities are contracted to provide Southern Cross Health Society members with certain procedures at agreed prices, and who streamline the prior approval and claims processes.

Note:

Southern Cross cover pre-existing conditions for new born children added to a policy within three months.

Those who already have a policy with Southern Cross can receive a child’s rate for their first two children, with third and subsequent children covered for free until age 21.